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From WikiMSK
WELCOME TO WIKIMSK
The New Zealand Musculoskeletal Medicine Wiki
Nau mai, haere mai! This website is a learning resource that is primarily designed for Musculoskeletal Medicine training in New Zealand. It also aims to be useful for GPs, other doctors, and medical students. It is not written for patients but they are welcome to read the articles. Click on a body region on the skeleton or a portal below to get started.
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Featured Wiki Article for 1 October 2024
Medicinal Cannabis
The evidence does not support the use of medicinal cannabis in Musculoskeletal Medicine - it is not effective for pain and it may in fact lower pain thresholds. - Read More
New and Updated Articles
- Alcohol and Chronic Pain
- Medicinal Cannabis
- Coccydynia
- Methadone
- Menopause and Chronic Pain
- Chronic Pain Assessment
- Medical History
- Smoking and Chronic Pain
- Acute Neck Pain
- Chronic Daily Headache
- Indomethacin Responsive Headaches
- Idiopathic Intracranial Hypertension
- Lacertus Syndrome
- Caloric Vestibular Stimulation
- Cervical Myelopathy
- Sensory Polyneuropathies
- Adult Acquired Flatfoot Deformity
- Diffuse Idiopathic Skeletal Hyperostosis
- Fibromyalgia
- Cerebrospinal Fluid Leak
Featured Open Access Journal Article for 1 October 2024
Daily cannabis use may cause cannabis-induced hyperalgesia
Am J Addict
ABSTRACT - Background and objectives: Public opinion about cannabis as a medical treatment is generally favorable. As many as 35% of primary care patients report medical use of cannabis, most commonly for pain treatment. We designed a way to test whether cannabis helps chronic pain.
Methods: A retrospective cohort study was conducted to explore whether daily long-term cannabis use was associated with increased pain sensitivity using the cold pressor test (CPT) to measure pain tolerance. Patients who used cannabis every day were compared to patients who inhaled tobacco and control patients who never used tobacco or cannabis. The effect of cannabis use on CPT was assessed using a generalized linear model. Results: Patients using cannabis daily had a median CPT of 46 s, similar to those who did not use cannabis but who inhaled tobacco (median CPT 45 s). Patients who used both cannabis and tobacco had the lowest CPT (median 26 s). The control group had a median CPT of 105 s. Cannabis use was associated with a significantly decreased pain tolerance (χ²(1) = 8.0, p = .004). The effect of tobacco on CPT was only marginally significant (χ²(1) = 3.8, p = .052).
Conclusion and scientific significance: This suggests a phenomenon similar to opioid-induced hyperalgesia; a drug that reduces pain short term, induces pain long term-opponent process. Daily cannabis use may make chronic pain worse over time by reducing pain tolerance. In terms of risk/benefit, daily cannabis users risk addiction without any long-term benefit for chronic pain.
“I will respect the hard-won scientific gains of those physicians in whose steps I walk, and gladly share such knowledge as is mine with those who are to follow.”
— The Hippocratic Oath: Modern Version, Lasagna 1964
